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July 14, 1900


JAMA. 1900;XXXV(2):99. doi:10.1001/jama.1900.02460280035013

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Many pathologic conditions offer indications for implantation of the ureters into the rectum or colon. As examples may be mentioned uretero-vaginal fistula; stricture and obliteration of the ureters under conditions preventing reinsertion of the ureter into the bladder; large vesico-vaginal fistulæ; tuberculosis and carcinoma of the bladder; and atrophy of the bladder. In these and other conditions, new routes for the discharge of the urine are desirable. Turning the urine into the rectum is not altogether against all physiologic precedent. In birds, for instance, there is a common route of exit for both urine and feces, and cases have been recorded in which the ureters emptied into the rectum in human beings, by virtue of the persistence of an early embryonic condition. Richardson's patient lived seventeen years, and without urinary incontinence. We have also learned that the rectum may acquire tolerance of the presence of urine. It is the occurrence

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